Rapid spread of pandemic in Asia dismays experts, spurs efforts to fight transmission

Article Abstract:

Much of the world has dealt with the reality of the AIDS epidemic for almost a decade. However, Asia was spared the initial onslaught. Now, this part of the world may have delayed too long in instituting programs for education and prevention. It may be too late now to avoid the rampant spread of AIDS in Asia, home to 60 percent of the world's population. The potential is staggering: in Bombay alone, it is estimated that 30,000 HIV-infected prostitutes are servicing 150,000 clients each day, exposing them to risk of infection. Health workers have been warning the Indian government for years that prevention programs were needed; the government dragged its heels while the rate of infection among some groups of prostitutes rose from 5 percent in 1985 to 80 percent in 1989. Thailand is the only Asian country with both a serious AIDS problem and a government AIDS-control program. AIDS first appeared in Thailand a few years ago among the intravenous drug users; today roughly 400,000 Thais are believed to be infected. One program is aimed at introducing the use of the ''female condom'' into the prostitution business. While the initial uptake of this unfamiliar device may be slow, health workers hope that ultimately other brothel workers and bar girls will follow the lead of their more innovative colleagues. AIDS is not avoiding the smaller countries; places like Indonesia and Singapore do not have the large numbers of AIDS cases of bigger nations, but the problem is nonetheless very real. In Singapore, there are few intravenous drug users, so the problem has not grown as it has in Thailand. However, while 2.5 million people live in Singapore, five million visit it each year. Officials expect that the number of cases of HIV infection and AIDS will rise for five or 10 more years before they begin to drop again. A combination of government conservatism and a false sense of security may have led Asian nations to the brink of unprecedented disaster. In the words an Indian professor, ''we are sitting on the top of a volcano.'' (Consumer Summary produced by Reliance Medical Information, Inc.)

Social policy, HIV infection, HIV infections, Asia, Epidemiological research, Cross sectional studies

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AIDS activities: from day 1 to 'something big'

Article Abstract:

The disease that became known as AIDS (acquired immunodeficiency syndrome) was mentioned in a 1981 Morbidity and Mortality Weekly Report, which is published by the Centers for Disease Control (CDC). The agency has led the epidemiological investigation of AIDS. A history of this research is provided. James W. Curran moved from the Sexually Transmitted Diseases program to co-ordinate the efforts of many experts. As new facts about the causal agent emerged, the group moved into the Center for Infectious Diseases, and, in 1985, when the agent was identified as a virus, into the Division of Viral Diseases. Other wings of the CDC became involved when the test for HIV (human immunodeficiency virus, the agent associated with AIDS) antibody was developed. The CDC sponsored the First International Conference on AIDS in June 1985, and the position of deputy director (HIV) was created the following year. The deputy director (HIV), Gary R. Noble, coordinates CDC's entire AIDS effort. The National AIDS Information/Education Program oversees education and the AIDS Hotline, among other projects. AIDS-related activities now make up 40 percent of the whole CDC budget; this figure is equal to one-third of the entire Public Health Service AIDS budget. James W. Curran, director of the Division of AIDS within CDC, heads groups working on epidemiology, surveillance, pediatric cases, and laboratory studies, among others. Studies of AIDS in Africa and Thailand also come under his aegis. A list of all the CDC agencies that study some aspect of the disease is provided. Dr. Noble recalls his early days at CDC and his earliest awareness of the disease now known as AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, AIDS research

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CDC veteran upholds the bottom line: prevention

Article Abstract:

A brief history of the CDC (Centers for Disease Control) and its deputy director, Walter R. Dowdle, is provided. Dowdle has been at the CDC for 30 years, having started as a research microbiologist in the Respiratory Virology Unit. He was involved in the development of tests which demonstrated that two types of herpesviruses infect humans: type 1 and type 2. The researcher's current position is consultant to the World Health Organization on its Global Programme on AIDS (acquired immunodeficiency syndrome). At one point during his career at CDC, two nonlab people died from infection caused by an experimental virus, the only such cases. He supported the construction of a maximum biocontainment laboratory, which was opened in 1988. This laboratory, called the Viral/Rickettsial Diseases Laboratory, contains a biologic safety level (BSL) 4 unit, a facility with such complex arrangements that only two others exist in the United States. Seven viruses will be handled there. Its high level of containment results from the controlled air flow and negative pressure in the most contained rooms. High efficiency particulate air filters are used, as well. Dowdle discusses the 'cycle of prevention', the approach taken to a public health problem. The agency has come a long way from its early days of fighting diseases to its present role of attempting prevention of violence, smoking and teenage pregnancy. Dowdle believes the overriding philosophy has remained the same: prevention. The only real change is the number of conditions that the CDC has taken on as targets. (Consumer Summary produced by Reliance Medical Information, Inc.)

Safety and security measures, Prevention, Communicable diseases, Medical laboratories, Biomedical laboratories, Epidemiology

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